Exploratory Surgery

Rebecca Gallo

Most patients who walk into Dr Richard Gallagher’s rooms at the St Vincent’s Clinic know that the news probably won’t be good. He is a head and neck specialist, and the country’s leading transoral robotic surgeon. Working at the cutting edge of his field, Richard introduced transoral robotic surgery to New South Wales, and has used an array of robotics to remove hundreds of cancers and benign tumours. When we meet, he has just come out of theatre where he removed part of a man’s jawbone along with tissue inside his mouth and underneath his tongue: “It sounds pretty gruesome, but there is a lot of finesse.”

It is not difficult to imagine the apprehension with which patients first approach Richard’s tenth-floor consulting rooms. They probably know they may be seriously ill, but often “it’s never really been explained to them that they have a cancer, and what that really means for them. That they might ultimately die from that cancer.” Death is a difficult topic, and many doctors shy away from using the word when talking to terminally ill patients. Richard is not one of them. The Gallaghers’s first selection from Artbank included a taxidermy sculpture by Louise Weaver, Golden Oriole (2000), which provided “an entry into the topic of death…people would look at the bird and say ‘is that going to be me?’”

Perhaps it is because we have been discussing art, but when I ask Richard about his work his response is surprisingly aesthetic. “One of the reasons that I love it is that the anatomy of the head and neck is beautiful. There’s nothing quite like it in the rest of the body. Every time that I expose tissues underneath the skin when we’re operating, it never ceases to give me a thrill just because it’s beautiful.”

Richard and his wife Shona, who founded and manage the practice together, are deeply committed to fostering trusting and honest patient-doctor relationships. Shona’s doctorate research into constructions of knowledge, power and authority within professions feeds into the self-aware, patient-focused ethos of the practice. In many cases Richard will direct a patient’s care over a number of years, and as such he wants the consultation rooms to be a “safe haven” for them.

This safe haven, however, is not a place to switch off or disengage. At reception, the document closest to hand is a room sheet with information about the artwork. Richard and Shona agree that they don’t expect—or even want— their patients to necessarily like the art. Although its clinical value is difficult to quantify, there is little doubt that the art in this space plays a role in both emotional and psychological realms: it directs focus, prompts reflection and absorbs feelings. For Richard, “it makes patients discuss some things that they wouldn’t otherwise discuss.” Shona finds that the artworks provide an outlet, as for patients, “there’s such a mix of emotions. The art gives them something to comment on, or to direct their focus…something else to react to.” It also provides “a place for nervous energy…for off-the-cuff responses.”